Biochemical markers of bone turnover, hip bone loss, and fracture in older men
Osteoporosis in men is an increasingly important concern and, compared with women, the pathophysiology of bone loss and fragility fractures in men is less well studied. Although sex hormones, cytokines, and other biological determinants likely play an important role, it is probable that these factors impact the male skeleton at least in part by their effects on bone turnover. In a recent study [1], the authors used data from the Osteoporotic Fractures in Men (MrOS) study to test the hypothesis that men with higher levels of bone turnover would have accelerated bone loss and an elevated risk of fracture.
FRAX and risk of Vertebral Fractures: the Fracture Intervention Trial
The validity of the WHO 10-yr probability of major osteoporotic fracture model (FRAX) for prediction of vertebral fracture has not been tested. The authors of a recent study [1] analyzed how well FRAX for major osteoporotic fractures (with and without femoral neck BMD) predicted the risk of vertebral fracture. They also compared the predictive validity of FRAX, femoral neck BMD, and prevalent vertebral fracture detected by radiographs at baseline alone or in combination to predict future vertebral fracture. They analyzed data from the Fracture Intervention Trial placebo groups (3.8-y follow-up, n = 3221).
Fall prevention with supplemental and active forms of Vitamin D
The objective of this study [1] was to test the efficacy of supplemental vitamin D and active forms of vitamin D with or without calcium in preventing falls among older individuals. This meta-analysis was performed by searching Medline, the Cochrane central register of controlled trials, BIOSIS, and Embase up to August 2008 for relevant articles. Further studies were identified by consulting clinical experts, bibliographies, and abstracts. Only double blind randomised controlled trials of older individuals (mean age 65 years or older) receiving a defined oral dose of supplemental vitamin D (vitamin D3 (cholecalciferol) or vitamin D2 (ergocalciferol)) or an active form of vitamin D (1α-hydroxyvitamin D3 or 1,25-dihydroxyvitamin D3) and with sufficiently specified fall assessment were considered for inclusion.
Increased bone resorption is associated with increased risk of cardiovascular events in men: the MINOS study
Better assessment of the association between cardiovascular disease and osteoporosis in older men may help identify shared etiologies for bone and heart health in this population. The authors of this study [1] assessed the association of BMD and bone turnover markers (BTMs) with risk of cardiovascular events (myocardial infarction or stroke) in 744 men > 50 yr of age.
Is QUS or DXA better for predicting the 10-Year absolute risk of fracture?
Although quantitative ultrasound (QUS) is known to be correlated with BMD and bone structure, its long-term predictive power for fractures in comparison with DXA is unclear. The authors of a recent study [1] examined this in a sample of men and women in the European Prospective Investigation into Cancer (EPIC)-Norfolk who had both heel QUS and hip DXA between 1995 and 1997.
 Download here the slide set presented by Prof. Friedlander, on Thursday, November 10th. |
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